Cost-Effectiveness and Heterogeneity: Using Finite Mixtures of Disease Activity Models to Identify and Analyze Phenotypes
Borg, Sixten LU ; Gerdtham, Ulf LU
; Rydén, Tobias
; Munkholm, Pia
; Odes, Selwyn
; Moum, Bjørn
; Stockbrügger, Reinhold
and Lindgren, Stefan
LU
(2015)
In Working Paper / Department of Economics, School of Economics and Management, Lund University
- Abstract
- Heterogeneity in patient populations is an important issue in health economic evaluations, as the cost-effectiveness of an intervention can vary between patient subgroups, and an intervention which is not cost-effective in the overall population may be cost-effective in particular subgroups. Identifying such subgroups is of interest in the allocation of healthcare resources. Our aim was to develop a method for cost-effectiveness analysis in heterogeneous chronic diseases, by identifying subgroups (phenotypes) directly relevant to the cost-effectiveness of an intervention, and by enabling cost-effectiveness analyses of the intervention in each of these phenotypes. We identified phenotypes based on healthcare resource utilization, using... (More)
- Heterogeneity in patient populations is an important issue in health economic evaluations, as the cost-effectiveness of an intervention can vary between patient subgroups, and an intervention which is not cost-effective in the overall population may be cost-effective in particular subgroups. Identifying such subgroups is of interest in the allocation of healthcare resources. Our aim was to develop a method for cost-effectiveness analysis in heterogeneous chronic diseases, by identifying subgroups (phenotypes) directly relevant to the cost-effectiveness of an intervention, and by enabling cost-effectiveness analyses of the intervention in each of these phenotypes. We identified phenotypes based on healthcare resource utilization, using finite mixtures of underlying disease activity models: first, an explicit disease activity model, and secondly, a model of aggregated disease activity. They differed with regards to time-dependence, level of detail, and what interventions they could evaluate. We used them for cost-effectiveness analyses of two hypothetical interventions. Allowing for different phenotypes improved model fit, and was a key step towards dealing with heterogeneity. The cost-effectiveness of the interventions varied substantially between phenotypes. Using underlying disease activity models for identifying phenotypes as well as cost-effectiveness analysis appears both feasible and useful in that they guide the decision to introduce an intervention. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/5049210
- author
- Borg, Sixten
LU
; Gerdtham, Ulf
LU
; Rydén, Tobias
; Munkholm, Pia
; Odes, Selwyn
; Moum, Bjørn
; Stockbrügger, Reinhold
and Lindgren, Stefan
LU
- organization
- publishing date
- 2015
- type
- Working paper/Preprint
- publication status
- published
- subject
- keywords
- Cost-effectiveness, Disease heterogeneity, Phenotypes, Latent classes, Disease activity model, Crohn's disease
- in
- Working Paper / Department of Economics, School of Economics and Management, Lund University
- issue
- 5
- pages
- 25 pages
- publisher
- Department of Economics, Lund University
- project
- Disease activity models of Inflammatory Bowel Diseases
- language
- English
- LU publication?
- yes
- id
- 35786f95-426f-4019-bf87-98736c5008eb (old id 5049210)
- alternative location
- http://swopec.hhs.se/lunewp/abs/lunewp2015_005.htm
- date added to LUP
- 2016-04-04 10:40:01
- date last changed
- 2019-03-08 02:54:05
@misc{35786f95-426f-4019-bf87-98736c5008eb,
abstract = {{Heterogeneity in patient populations is an important issue in health economic evaluations, as the cost-effectiveness of an intervention can vary between patient subgroups, and an intervention which is not cost-effective in the overall population may be cost-effective in particular subgroups. Identifying such subgroups is of interest in the allocation of healthcare resources. Our aim was to develop a method for cost-effectiveness analysis in heterogeneous chronic diseases, by identifying subgroups (phenotypes) directly relevant to the cost-effectiveness of an intervention, and by enabling cost-effectiveness analyses of the intervention in each of these phenotypes. We identified phenotypes based on healthcare resource utilization, using finite mixtures of underlying disease activity models: first, an explicit disease activity model, and secondly, a model of aggregated disease activity. They differed with regards to time-dependence, level of detail, and what interventions they could evaluate. We used them for cost-effectiveness analyses of two hypothetical interventions. Allowing for different phenotypes improved model fit, and was a key step towards dealing with heterogeneity. The cost-effectiveness of the interventions varied substantially between phenotypes. Using underlying disease activity models for identifying phenotypes as well as cost-effectiveness analysis appears both feasible and useful in that they guide the decision to introduce an intervention.}},
author = {{Borg, Sixten and Gerdtham, Ulf and Rydén, Tobias and Munkholm, Pia and Odes, Selwyn and Moum, Bjørn and Stockbrügger, Reinhold and Lindgren, Stefan}},
keywords = {{Cost-effectiveness; Disease heterogeneity; Phenotypes; Latent classes; Disease activity model; Crohn's disease}},
language = {{eng}},
note = {{Working Paper}},
number = {{5}},
publisher = {{Department of Economics, Lund University}},
series = {{Working Paper / Department of Economics, School of Economics and Management, Lund University}},
title = {{Cost-Effectiveness and Heterogeneity: Using Finite Mixtures of Disease Activity Models to Identify and Analyze Phenotypes}},
url = {{http://swopec.hhs.se/lunewp/abs/lunewp2015_005.htm}},
year = {{2015}},
}